St. Mary's Medical Center

St. Mary’s Medical Center Community Benefit 2020 Report and 2021 Plan Adopted October 2020 Table of Contents At-a-Glance Summary 4 Our Hospital and the Community Served 6 About St. Mary’s Medical Center 6 Our Mission 6 Financial Assistance for Medically Necessary Care 6 Description of the Community Served 6 Community Need Index 8 Community Assessment and Significant Needs 9 Community Health Needs Assessment 9 Significant Health Needs 9 2020 Report and 2021 Plan 11 Creating the Community Benefit Plan 11 Impact of the Coronavirus Pandemic 13 Report and Plan by Health Need 14 Community Grants Program 17 Program Digests 18 Other Programs and Non-Quantifiable Benefits 24 Economic Value of Community Benefit 27 Hospital Board and Committee Rosters 28 Financial Assistance Policy Summary 29 Community Benefit FY 2020 Report and FY 2021 Plan St. Mary’s Medical Center | 3 At-a-Glance Summary Community Located in northern California, San Francisco is a seven by seven square mile Served coastal, metropolitan city and county that includes Treasure Island and Yerba Buena Island, just northeast of the mainland. The only consolidated city and county in the state, San Francisco is densely populated and boasts culturally diverse neighborhoods in which residents speak more than 12 different languages. The city is characterized by steep inequality with ten percent of its population living below the federal poverty level, while at the same time hosting the third most billionaires in the world. Economic $34,470,367 in patient financial assistance, unreimbursed costs of Medicaid, Value of community health improvement services, community grants and other community Community benefits Benefit $58,033,645 in unreimbursed costs of caring for patients covered by Medicare Significant The significant community health needs the hospital is helping to address and that Community form the basis of this document were identified in the hospital’s most recent Health Needs Community Health Needs Assessment (CHNA). Needs being addressed by Being strategies and programs are: Addressed Foundational Issues: Health Needs (Continued): • Racial health inequities • Food security, healthy eating and • Poverty active living • Housing security and an end to Health Needs: homelessness • Access to coordinated, • Safety from violence and trauma culturally and • Social, emotional, and behavioral linguistically appropriate health care and services FY20 Programs The hospital delivered several programs and services to help address identified and Services significant community health needs. These included: • Sister Mary Philippa Health Center (SMPHC): serves as a medical home to underinsured and uninsured patients offering primary care as well as specialty clinics. • Counseling Enriched Education Program offers qualified students of SF Unified School District classroom instruction at St. Mary’s by SFUSD teachers with mental health professionals on-site to provide intensive therapy and treatment. • Graduate Medical Education: Provides graduate education to resident Community Benefit FY 2020 Report and FY 2021 Plan St. Mary’s Medical Center | 4 internal medicine physicians, orthopedic surgeons and podiatrists. Internal medicine residents also gain experience as primary care providers through the SMPHC. • Diabetes Services: Provides education (individual and group), outreach and support to community members. FY21 Planned The hospital plans to continue prior year programs and activities to address Programs and significant community health needs. As the coronavirus pandemic continues, the Services hospital will work with its partners to continue to address the evolving health needs. This document is publicly available online at https://www.dignityhealth.org/bayarea/locations/stmarys/about-us/community-benefit Written comments on this report can be sent by mail or emailed to [email protected]. Mailed comments should be addressed to: St. Mary’s Medical Center Community Health Department 450 Stanyan St. San Francisco CA 94117 Community Benefit FY 2020 Report and FY 2021 Plan St. Mary’s Medical Center | 5 Our Hospital and the Community Served About St. Mary’s Medical Center St. Mary’s Medical Center is a member of Dignity Health, which is a part of CommonSpirit Health. The hospital was founded by the Sisters of Mercy and has cared for the people of the San Francisco Bay Area since 1857. In 1986 it was one of the founding hospitals of Dignity Health. A fully accredited teaching hospital in the heart of San Francisco, it has 275 licensed beds. For 163 years, St. Mary’s has built a reputation for quality, personalized care, patient satisfaction, and exceptional clinical outcomes. Our key service lines include orthopedics, cardiovascular, oncology, adolescent psychiatry, and acute rehabilitation. We offer a full range of diagnostic services and a 24-hour Emergency Department. Our Mission As CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all. Our Vision A healthier future for all – inspired by faith, driven by innovation, and powered by our humanity. Financial Assistance for Medically Necessary Care St. Mary’s Medical Center delivers compassionate, high- quality, affordable health care and advocates for members of our community who are poor and disenfranchised. In furtherance of our mission, the hospital provides financial assistance to eligible patients who cannot pay for medically necessary health care services, and who otherwise may not receive these services. A plain-language summary of the policy is at the end of this report. The financial assistance policy and plain language summary are on the hospital’s web site. Description of the Community Served St. Mary’s Medical Center serves the City and County of San Francisco. A summary description of the community is below. Additional details can be found in the CHNA report online. St. Mary’s Medical Center is an acute care hospital and ambulatory health care provider serving a geographic Community Benefit FY 2020 Report and FY 2021 Plan St. Mary’s Medical Center | 6 service area that includes San Francisco, Northern San Mateo County and Southern Marin County. For Community Benefit activities we focus on the City and County of San Francisco. San Francisco, at roughly 47 square miles, is the most densely populated large city in California. Between 2011 and 2018, San Francisco grew by almost eight percent to 888,817 persons outpacing population growth in California (6 percent). By 2030, San Francisco’s population is expected to total more than 980,000. The population is aging and the ethnic shifts continue with an increase in the Asian and Pacific Islander population, increase in multiethnic populations and a decrease in the Black/African American population. Although San Francisco has a relatively small proportion of households with children (19 percent) compared to the state overall (34 percent), the number of school-aged children is projected to rise. Despite areas of affluence, there remain significant pockets of poverty (as evidenced in the Community Needs Index which follows) particularly in the African American and Hispanic/Latino communities. Because of our proximity to Golden Gate Park, our emergency department sees a large number of people who are homeless and others lacking access to primary care. San Francisco has historically been on the forefront in providing access to health services for its citizens. Since 2007, the Healthy San Francisco program has been in operation, funded by the city, employer contributions and participant fees as well as being subsidized by private hospitals including SMMC. In FY 2020 we provided $703,667 to this means-tested program. Healthy San Francisco has offered medical services to San Franciscans regardless of their income, employment or immigration status or pre-existing medical conditions. San Francisco Total Population 893,803 Race White - Non-Hispanic 39.5% Black/African American - Non-Hispanic 4.7% Hispanic or Latino 15.6% Asian/Pacific Islander 36.1% All Others 4.2% Total Hispanic & Race 100.0% % Below Poverty 5.4% Unemployment 4.1% No High School Diploma 11.9% Medicaid (% of households)_ 7.6% Uninsured (% of households) 2.8% Source: Claritas Pop-Facts® 2020; SG2 Market Demographic Module Community Benefit FY 2020 Report and FY 2021 Plan St. Mary’s Medical Center | 7 Community Need Index One tool used to assess health need is the Community Need Index (CNI) created and made publicly available by Dignity Health and IBM Watson Health. The CNI analyzes data at the zip code level on five factors known to contribute or be barriers to health care access: income, culture/language, education, housing status, and insurance coverage. Scores from 1.0 (lowest barriers) to 5.0 (highest barriers) for each factor are averaged to calculate a CNI score for each zip code in the community. Research has shown that communities with the highest CNI scores experience twice the rate of hospital admissions for ambulatory care sensitive conditions as those with the lowest scores. Community Benefit FY 2020 Report and FY 2021 Plan St. Mary’s Medical Center | 8 Community Assessment and Significant Needs The hospital engages in multiple activities to conduct its community health improvement planning process. These include, but are not limited, to conducting a Community Health Needs Assessment with community input at least every three years, identifying collaborating

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